When the US Food and Drug Administration (FDA) approved another opioid in the midst of rampant overdose deaths, the agency faced harsh criticism. Opponents said the country didn’t need a drug that’s up to 10 times more powerful than fentanyl, which has driven the current wave. But the agency countered with an appeal for its critics to take a broader view. Evaluate a potential new opioid not only as an individual drug, but also based on how it compares with other opioids and the unique niche it might fill, former FDA Commissioner Scott Gottlieb, MD, proposed.